When you’ve written a book that almost instantly becomes a cultural phenomenon, what do you do for an encore? That was the dilemma facing Malcolm Gladwell 25 years after the publication of THE TIPPING POINT. Not content to simply reprise the success of his previous work with an updated version, Gladwell has embarked on a new, but at least familiar-feeling, path. The result is REVENGE OF THE TIPPING POINT: Overstories, Superspreaders, and the Rise of Social Engineering, which Gladwell calls “a guide to the fevers and contagions that surround us” --- and a thought-provoking one at that.

Gladwell admits that times have changed significantly since the comparatively benign days at the end of the 20th century that produced a “hopeful book” that focused on “how to promote positive social change.” Instead, in this “forensic investigation of social epidemics,” he describes how “the very same tools we use to build a better world can also be used against us.”

"Sit back, enjoy the ride and come away from REVENGE OF THE TIPPING POINT with a perspective that may allow you to see aspects of our world and how it responds to change with fresh eyes."

That’s the reason REVENGE OF THE TIPPING POINT is bookended by the grim story of Purdue Pharma and how its relentless marketing of the powerful painkiller OxyContin drove the opioid epidemic responsible for the deaths of more than 80,000 Americans in 2023 alone. But before the book arrives at its climactic chapter, Gladwell takes the reader on a journey that’s both entertaining and enlightening, unearthing the concepts underlying his explanation for why the actions of Purdue and the Sackler family proved so profitable and so lethal.

Like its predecessor, Gladwell’s latest is a blend of engaging and slightly offbeat storytelling, summaries of pertinent social science research, and Gladwell’s signature spin on the result. Along the occasionally meandering way, for example, he offers an account of the Lawrence Tract, a controversial experiment in 1950s Palo Alto, California, designed by local neighbors to combat the phenomenon of white flight; explains how the creation of a women’s rugby team at Harvard University (along with sports like fencing and crew) are crucial to the university’s efforts to maintain the current composition of its student body; and argues that an NBC miniseries in 1978 deserves much of the credit for raising the consciousness of Americans about the horrors of the Holocaust.

Gladwell has a knack for synthesizing his material and attaching to it a memorable label that allows the concept to lodge in the mind. One example is the notion of the “Magic Third,” the idea that the presence of a critical mass of approximately 30 percent --- as in women on a corporate board or the percentage of nonwhite residents responsible for “tipping” a neighborhood in the odious calculus of white flight --- is necessary to initiate social change, both positive and negative.

Critical to Gladwell’s explanation of the spread of social contagion is an idea he calls the “overstory” (i.e., “things way up in the air, in many cases outside our awareness”), the concept of “group proportions” (epidemics spread more quickly in “monocultures” than in heterogeneous ones), and the “Law of the Few”--- or, to use his shorthand, “superspreaders,” a concept he presents in the context of the Biogen leadership retreat in Boston in February 2020 to explain how one person likely was responsible for introducing the COVID virus that eventually resulted in more than 300,000 infections.

As Gladwell describes in his book’s chilling last chapter, all three of these phenomena coalesced to ignite the final and deadliest phase of the opioid epidemic. The “overstory” of the epidemic was the much higher rates of opioid overdoses in states that did not require physicians to write prescriptions for pain medications in triplicate and file them with regulators than those who did. In 2010, Purdue introduced a new version of OxyContin that could not be crushed and snorted. But instead of reducing the numbers of those who abused the drug, it turned more of them into fentanyl and heroin addicts, thus changing the “group proportions” dramatically. Finally, it required only a relatively small number of unscrupulous physicians, aggressively recruited by the financially incentivized Purdue sales force, to account for a massive percentage of the prescriptions for the new formulation OxyContin OP, turbocharging Gladwell’s “Law of the Few” into what he regretfully calls the “Law of the Very, Very, Very Few.”

Undoubtedly, some critics will find Gladwell’s explanation for this tragedy facile, and perhaps even he would concede that there’s at least a grain of truth in that charge. “I hold ideas very loosely,” he admitted in a recent New York Times interview, and he urges his readers to approach his work in that spirit. “It’s fine to have a beautiful idea that you’re presenting to people and helping them make sense of the way the world operates,” he says. “But I do think that you have to communicate the understanding that this could be wrong. We’re not presenting a fact here. We’re playing with an idea.”

In that spirit, it’s fair to conclude that not everyone will agree with all of Gladwell’s theories, or even some of their factual underpinnings. But agreement isn’t essential to an appreciation of this stimulating book. Sit back, enjoy the ride and come away from REVENGE OF THE TIPPING POINT with a perspective that may allow you to see aspects of our world and how it responds to change with fresh eyes.